Withholding Judgment

Ethical questions about sex and Alzheimer's disease

by John Portmann

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In 2007, the story of Justice O’Connor’s sudden retirement from the Supreme Court mesmerized me. One of the most powerful women in America voluntarily left her career in order to care for her husband, who was suffering from Alzheimer’s disease. The twist was that he no longer knew who O’Connor was and had fallen in love with another woman, who also had Alzheimer’s. O’Connor blessed the romance, however, because, she said, it made him happy. Having lived in Paris after college, I was familiar with the idea of an upper-class woman tolerating her husband’s mistress. I had never heard of an Alzheimer’s wrinkle to the traditional romance, though.

As someone who studies sexual ethics, I kept wondering what O’Connor’s reaction meant in a country in which people are living longer and longer and in which Alzheimer’s is becoming more prevalent. Was her husband guilty of adultery? Was she still supposed to satisfy him sexually, as she had likely promised to do in her marriage vows, if, as an Episcopalian, she had taken traditional Christian vows? What became of her husband’s promise to satisfy her sexual needs? And what would America say if O’Connor, no doubt distraught and exhausted over her husband’s illness, fell in love with a new man? Would that be adultery?

John Portmann

I combed the past for clues. I knew that for many centuries, Jews and Christians condemned divorce. Marriage was forever. But the medieval Catholic Church recognized several escape clauses. If a woman married a man who became impotent, she could divorce him. She could also pack her bags if her husband contracted leprosy or hadn’t returned from a war or even a sales trip long after he had been expected back.

It might seem that these examples argue for allowing Alzheimer’s “widows” and “widowers” to fall in love again before their legal spouses die. Unlike cancer and various other diseases that claim their victims within a couple of years, Alzheimer’s can stretch on for decades. And so I argue for showing compassion to those people married to Alzheimer’s patients who fall in love again sooner rather than later. Around the United States, anecdotal evidence suggests that many people “married to Alzheimer’s” are already doing this in secret.

Just as the generation that came of age in the 1960s showed us that people who have sex before marriage are not necessarily immoral, people of the same generation are now showing us that marriage in the time of Alzheimer’s has grown even more complicated, and that those faced with these questions of sexuality and fidelity later in life should not be judged too quickly. Instead, we should allow them to follow O’Connor’s example of navigating a sacred union with boundless generosity—toward their spouses, and themselves.

John Portmann is an associate professor of religious studies at UVA. His latest book is The Ethics of Sex and Alzheimer’s.